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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME <br /> <br />1(;;;:tt\ (JJ, c,~~~ IA(P~ <br /> <br />OWNER'S ADDRESS~ N'\~r \t ~ <br />t;y S~ ) 8'" 5\- <br /> <br />PHONE <br />2-h:((~ 5S~l/ <br /> <br />S~I <br /> <br />gJ-'7S <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />5~ t.-) <br /> <br />BLOCK J 1./ b SUBDIVISION <br /> <br />PARCEL I.D..-1 J -21,.,-)\ ~ 00100 i'1 l:IJn {'JC, ~o <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction ~ddition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_De.olish <br /> <br />PROPOSED USE: _Single Family <br /> <br />_K/F <br /> <br />_, of Units _K/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swu.. Pool ___Other <br /> <br />_Restaurant & Health Depar~ent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />Ovlcl <br /> <br />~ <br /><;.p '- I <br />,rlJ...IC e \ (") <br /> <br />(1~~o.~ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />-I no <br />$ <br /> <br />AMP Service <br /> <br />L/ Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />_HECHAlUCAL <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _FrUle _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />**************......*****.*.******..**..** <br /> <br />Signature <br /> <br />ELECTRICIAR <br />~/~~ <br />Si~Ature /' L <br /> <br />...-- <br />COMPANY 1--- ~ ~ <br />~ State Cert. or Regist. t <br />2;-) ~.A'" City License Registration # .1'# <br />***** *******.*..**..*********..****.***.. <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />**************.*******.************..***** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration . <br />*******************************.********** <br /> <br />Signature <br /> <br />OTRF.R <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />